Systematic reviews of controlled clinical studies of treatments used by chiropractors have not found evidence that
chiropractic manipulation is
effective, with the possible exception of treatment for
back pain.
[7] A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition.
[8] Spinal manipulation may be
cost-effective for sub-acute or chronic low back pain but the results for acute low back pain were insufficient.
[9] The efficacy and cost-effectiveness of maintenance chiropractic care are unknown.
[10] There is not sufficient data to establish the safety of chiropractic manipulations.
[11] It is frequently associated with mild to moderate
adverse effects, with serious or fatal complications in rare cases.
[12] There is controversy regarding the degree of risk of
vertebral artery dissection, which can lead to
stroke and death, from
cervical manipulation.
[13] Several deaths have been associated with this technique
[12] and it has been suggested that the relationship is
causative,
[14][15] a claim which is disputed by many chiropractors.